This will be an observational study to explore differences in pathophysiology between groups of people with and without heart failure (HF) (reduced and preserved ejection fraction) and with and without diabetes mellitus (DM) with a particular focus on cross-talk (fat, muscle, vascular tissue and the heart). The investigators will invite 600 people to partcipate (100 with HFrEF+DM, 100 with HFpEF+DM, 100 with HFpEF-DM, 100 with HFrEF-DM, 100 with DM, 100 without either HR or DM). Special heart scans, exercise testing, blood testing, testing of the automatic nervous system will be performed and in some, samples of fat and muscle and endothelial cells will be collected.
These data will be used to create a cohort of well phenotyped patients with a variety of comprehensively collected clinical information, a cell atlas, and a comprehensive assessment of metabolomics, proeomics and cross-talk in between tissues, allowing comparisons between each group.
Age >18 years
Ability to provide written informed consent
Persons who are legally competent and mentally able to follow the instructions of the study staff
Anaemia Hb <8 mg/dl
Patients with acute infectious diseases (e.g. pneumonia)
Patients with heart failure due to sepsis
People with acute myocardial ischemia, which is manifested, for example, by angina pectoris or ECG changes under stress
People attending heart failure clinics, diabetes clinics (either secondary or primary care) or control subjects attending hospital with relatives or accumulated from the community by word of mouth or advertisement.
Cohort
Cross-sectional
Not listed
6
Trial groupsSee each trial group below.
Study primary endpoint
Are there differences in skeletal muscle cellular metabolism assessed by mass spectrometry-based metabolomics and lipidomics between the two phenotypes of heart failure compared with controls and what influence does diabetes mellitus have?
Secondary outcome 1
How does T2DM influence intercellular communication to promote the progression of HF
Secondary outcome 2
Are there correlations between abnormalities in these cells and cardiac abnormalities, patient symptoms and clinical outcomes?
Secondary outcome 3
What metabolic pathways are abnormal in people with heart failure, diabetes mellitus and both?
Secondary outcome 4
Can we identify using metabolomics, a substrate or compound that underlies the metabolic abnormalities?
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